Swallowed By The Cracks e-Pub

by Lee Thomas, Gary McMahon, S. G. Browne, Michael Marshall Smith

  Instead, she asks me the questions while taking the samples. Except for the one about being pregnant. And this test didn't require me to fast. I'm not a big fan of fasting. I'm not Bahá'í or Buddhist and I've never spent forty days and nights on a mountain with God, so abstaining from food and drink has never been my strong suit.

  After she draws my blood, the phlebotomist hands me a sterile plastic specimen container with my name and date on it and points me to the bathroom.

  "Try to catch the urine in mid-stream," she says. "It makes for a cleaner sample."

  I nod as if this is something I've never heard before. As if this is my first time.

  Collecting a specimen mid-stream doesn't mean inserting the specimen cup into the flow of urine. It takes a talented individual to manage that without pissing all over the side of the cup, not to mention all over your hand and splattering the toilet and floor. No. What you do is, first you wash out the urethra. You do this by releasing a short, initial stream into the toilet. Ideally, you'd use an antiseptic pad to sterilize the opening of the urethra first, but most clinics don't require that degree of cleanliness. After the initial stream, you stop, then resume urination into the container, collecting the sample before the stream ends.

  I've heard some guys have a hard time peeing on command into a cup, so they collect a sample at home in a sterile container and bring it in. I've never had a problem providing a sample, so I give them a mid-stream catch, then deposit the specimen container in the cabinet, grab my backpack, and head to the waiting room, where the receptionist gives me a list of dietary requirements and a checklist of side-effects.

  "Thank you, Mr. Prescott," she says. "See you next week."

  * * * * *

  I'm a professional guinea pig.

  Not exactly something you go to college for or intern at a prestigious law firm to gain experience as or dream of being when you're a kid.

  "What do you want to be when you grow up?"

  "I want to test drugs that might make me vomit or experience uncontrollable flatulence."

  This is why they have high school guidance counselors.

  Someone to give us direction. Purpose. Some sense of a future that doesn't involve selling yourself for medical research or starring in bad porn. But sometimes circumstances dictate a future you hadn't planned for, so you do what you have to do.

  Most professional guinea pigs volunteer for Phase I pharmaceutical clinical trials, where the safety of a potential drug is tested by giving it to more or less healthy subjects and studying any side effects. Phase II trials involve determining dosing requirements and effectiveness. Phase III trials compare a drug's results with standard treatments.

  I'm in the first category. The Phase I trials.

  I take generic painkillers, heart medications, anti-depressants. Investigative drugs being developed and tested for market entrance.

  Drugs for ADD, insomnia, and urinary tract infections.

  Drugs for schizophrenia, impotence, and Parkinson's disease.

  Drugs with names like Lorazepam and Naproxen and Adderall.

  Unlike test subjects in later-stage clinical trials, who are usually sick and enroll in a study to gain access to a new drug, guinea pigs in early-stage trials can't expect any therapeutic benefit. And every time we volunteer to be tested for some new drug, we're putting ourselves at risk. But sometimes life provides opportunities that you never thought you'd have to take, so you take them in spite of the risks. Plus, it's not like I'm doing this for free.

  Nobody's volunteering out of the goodness of their heart.

  In a typical month, I make $1500, sometimes as much as $3000, but I've never made less than $1000. Generic testing studies usually take place over two weekends and pay anywhere form $600 to $1000. While I only received $500 for my recent Paleolithic diet study, that only lasted a week and didn't require a washout, which is the thirty-day waiting period required between most studies.

  A lot of these drugs I've been tested with, the ones that have already passed the final stage of clinical trials and are now legally available by prescription and advertised on television, come with a host of common side-effects in addition to their advertised health benefits.

  Blurred vision.

  Diarrhea.

  Vomiting.

  These are the less serious side effects. The ones that don't require you to call your doctor or make you wonder if it's too late to take out life insurance.

  But then there are the more serious side effects, the ones you hear rattled off on a commercial like a contest disclaimer.

  May cause fainting.

  May cause seizures.

  May cause hallucinations.

  Only one entry per household.

  Must be eighteen or over to be eligible.

  Residents of California and Arizona must pay tax.

  Then there are the drugs that actually cause the very problem they're supposed to be treating.

  Drugs to treat diarrhea that can cause diarrhea.

  Drugs for sleep disorders that can cause insomnia.

  Drugs to combat depression that can cause suicidal thoughts.

  One drug, an anti-inflammatory taken for arthritis, tendinitis, bursitis, gout, and menstrual cramps, suggests that you stop taking the medication and seek immediate medical attention if you experience any of the following:

  Slurred speech.

  Blistering or peeling of the skin.

  Coughing up blood or vomit that looks like coffee grounds.

  There's more, including jaundice, bloody stools, numbness, and chills. But if my skin is blistering and I'm having trouble speaking and I'm throwing up something that has the consistency of Starbucks Breakfast Blend, I'm thinking maybe this drug needs to be taken off the shelves.

  It makes you wonder how something like this gets approved by the FDA while medical marijuana shops get shut down.

  Still, the overall safety of all of these new drugs depends on the willingness of someone to test them. Someone who needs the money. Someone who has a lot of time to spare.

  Someone who has no better option.

  This isn't something computer engineers do. This isn't something college professors do. This isn't something lawyers or CEO's or members of congress do.

  This is something the less advantaged do so the rich can get better drugs.

  Of course, you can't always depend on a regular paycheck or a steady monthly income from guinea-pigging, which means you have to find other ways to make ends meet.

  * * * * *

  "Get a job you lazy whore," says a forty something married man in a tie and slacks who throws a dollar into my hat as he walks past.

  I thank him and wish him a nice day.

  "Shove this up your ass," says a guy in his twenties who works at the Children's Zoo and displays a George Washington around his middle finger before tossing the dollar into my hat.

  I give him a nod and a smile.

  "You're lousy in bed," says a woman in her early thirties who throws a handful of singles into my hat. She gets a couple of steps away, then turns around, marches back over to me, and hisses, "You're the worst fuck I've ever had!"

  I press my hands together in front of me and bow my head.

  I'm in Central Park, sitting on a bench near the Naumburg Bandshell. The sign I'm displaying today says:

  Will take verbal abuse for money.

  When I first started using this sign a couple of years ago, I received the standard insults you'd expect, derogatory comments meant for me and my wasted life. For what I represented. For what I'd become.

  A social tumor.

  A rash on the ass of civilization.

  An oozing pus bag of failure.

 
More often than not, the insults weren't accompanied by a donation. Sometimes I got spit on, which isn't technically verbal abuse, but when you're a panhandler, you can't expect everyone to be on the same page.

  But after a while, after people saw me around Central Park with my sign on a regular basis, they started to feel comfortable with me. They started to understand the freedom I was offering. They started to open up.

  People don't always have someone to talk to. Someone they can be honest with. Someone who will listen to all of the things they wish they could say without passing judgment. Plus I'm non-threatening. An outsider. A familiar stranger. Someone they don't have to worry about running into at the office or the local bar or family reunions. Unless they happen to hold their reunion in Central Park.

  Now when most people approach me, rather than showering me with personal attacks and derogatory invectives about my existence, they vent their frustrations about anything that's troubling them. The problems that they're unable to deal with. Whatever's on their mind that they can't share with anyone else.

  Jobs.

  Relationships.

  Family.

  "I hate you, Mom," says a young woman wearing a Columbia University sweatshirt who tosses a wadded up dollar at me. "You've ruined my life."

  I get that a lot.

  It doesn't matter if the object of their frustration and anger is male or female, mother or father, husband or wife. I'm an androgynous receptacle of disparagement. An ambiguous catch-all of angst.

  I'm kind of like a mendicant therapist.

  A panhandling priest.

  Absolving the sins of my flock for whatever they care to leave as a contribution. Offering a sliding scale of emotional succor.

  Sometimes I use other signs with different sayings, like:

  Professional panhandler. How can I help you?

  Looking for a little humanity. Have you seen him?

  If we were both squirrels, I could show you my nuts.

  That one doesn't always work so well. Still, it makes me laugh, and a happy panhandler is a prosperous panhandler. But none of the other signs offer the same sense of purpose as the service I'm providing today.

  So I sit and I listen and I smile and I thank them for their words and their donations and their abuse and by the end of my four hours, I've earned eighty-seven dollars and change. Which is a good seven dollars more an hour than I typically earn using any of my other signs. At that rate, doing this full-time, I would earn more than forty-five grand a year.

  Tax free.

  But if I used the same sign every day, it wouldn't carry the same weight. I'd become just another unimaginative panhandler, preying on the good will of my customers. Which is why I like to mix things up. Plus it makes me appreciate days like this.

  As I start to collect my money and my sign, a teenager on a skateboard rides up to me, calls me a dream crushing asshole, then throws a handful of quarters at me.

  At least I know I'm making a difference.

  I pick up the quarters, which have scattered across the concrete at my feet, and call out a "Thank you" to the kid as he starts to ride away, when my lips go numb again. At the same moment the kid glances back to give me the finger, I let out a yawn. The next thing I know, the kid tumbles to the ground in an unconscious heap, his skateboard rolling away into the grass.

  I look around to see if anyone else noticed but no one is paying attention. Or at least if they are, they're ignoring it. Which is typical for New York. Everyone wears blinders unless something directly affects them. So I walk over to the kid to see if he's okay.

  He's on his back, out cold, his head turned to one side. His lips are moving but I can't hear what he's saying, so I kneel down next to him.

  "Hey," I say, shaking him gently by the shoulder. "Are you okay?"

  He moves and I think he's coming around. But instead of opening his eyes and sitting up, he rolls on to his side, puts his hands under his head, and curls up in a fetal position.

  * * * * *

  "Anybody have anything weird happen to them lately?" I ask.

  "Weird?" says Charlie. "What kind of weird?"

  "Weird," I say. "The kind of weird that makes you wonder if there's something going on that you don't know about."

  "I have that all the time," says Randy. "It's called women."

  A few days later I'm at Caffé Reggio on MacDougal in Greenwich Village with Vic, Charlie, Frank, and Randy – four other guinea pigs who test pharmaceutical drugs. This is our monthly meeting where we share info on clinical trials, including how well a study paid, the competence of the venipuncturist, and the quality of the food. All of the important factors that we take into account before volunteering for a trial. We're kind of like a guinea pig coffee klatch.

  "When you say weird," says Vic, "are you talking about with you or with other people?"

  "Other people," I say. "Though I have been kind of tired lately."

  "You been upping your carbohydrate intake?" asks Frank.

  Certain carbohydrates with a high glycemic index break down fast and cause a steep rise in blood sugar levels, causing an initial rush that's followed by periods of drowsiness. Foods with a high glycemic index include French fries, instant rice, corn flakes, pretzels, and frozen waffles.

  "Not really," I say.

  "Not really?" says Frank. "What the hell does that mean? You've either been upping your intake or you haven't. Jesus, don't you keep track of what you're consuming?"

  Frank takes being a guinea pig very seriously.

  "Have you gained weight?" asks Charlie, looking at Frank.

  "What the hell has that got to do with anything?" asks Frank, taking a bite of his cannoli.

  "It's just a question," says Charlie. "You don't need to get defensive."

  "I'm not getting defensive," says Frank, who, to be honest, looks a little plumper these days. "I just don't understand what my weight has to do with Neal's inability to keep accurate records of his caffeine intake."

  "Maybe you should chill out," says Randy, scratching at his head.

  "Maybe you should shut the fuck up," says Frank, shoving the last of the cannoli into his mouth.

  Everyone seems to be a little more irritable today than usual. But when you spend your existence taking experimental prescription drugs that give you headaches and constipation and insomnia, irritability is just a comment away. Not to mention that we don't get any retirement benefits, disability insurance, worker's compensation, or overtime pay. Plus we're not going to get the benefits of the health care developed by the research we're helping to test, since most of us can't even afford health insurance. So we're only one bad trial away from hospital bills and bankruptcy and homelessness.

  "Can we get back to Neal's question about things being weird?" says Vic.

  "Yeah," says Charlie, who shivers once like he just got a chill. Which is odd because it's eighty degrees out. "What exactly are we talking about here?"

  In addition to feeling tired lately, I tell them about the numbness I've started having in my lips.

  "Did you report it?" asks Frank.

  I shake my head, which causes Frank to go into lecture mode about personal responsibility. Then I tell them about the kid on the skateboard.

  "And he passed out the same moment you yawned?" asks Vic.

  "Yeah," I say. "At least it seemed like it."

  "It was just a coincidence," says Frank.

  "Maybe," I say. "But it was a pretty weird coincidence."

  "Anybody else have anything weird happen to them?" asks Charlie.

  Frank shakes his head while Randy scratches at his, looking like he has something on his mind. Vic lets out a burp and makes a face.

  I look over at Vic who glances
back at me and I think he's going to say something, but then Randy starts talking about how the last research facility he stayed at over the weekend could use a good public relations director and the conversation turns to business.

  We spend the next fifteen to twenty minutes talking about our recent trials, comparing notes, grading clinics. We give each research unit a grade from A to F, factoring in a number of conditions and variables, such as the friendliness of the staff, how much they pay, the drugs being tested, the side effects, and the length of the trial.

  It's nice having a support group of your peers to help navigate the waters of being a professional guinea pig. There aren't any agencies out there to help us. So we pretty much have to look out for ourselves.

  "Any of you feel nauseous?" asks Vic, out of nowhere, looking around the table. "Not right now but I mean, in general?"

  "No," I say.

  Everyone else either answers in the negative or shakes his head.

  "I feel nauseous sometimes," says Vic. "A lot lately, actually. But only when I burp."

  Which explains the face he made a while back.

  "My head itches a lot," says Randy, scratching his head. "It never used to."

  Frank, who is sitting next to Randy and eating another cannoli, scoots further away.

  Then Vic leans forward so only we can hear him and he says, "I think I'm making other people throw up."

  * * * * *

  I walk through the streets of Lower Manhattan, though Tribeca and Soho and Chinatown, past stores and restaurants and subway stations. Past people who need help.

  A homeless man talking to himself out in front of St. Peter's Church.

  A bag lady moving her five bags down Lafayette Street one at a time.

  A drunk passed out on the sidewalk near the Delancey Station entrance.

  I read the news every day and see stories about people getting robbed on the subway or mugged in Central Park. The disadvantaged and the elderly and the homeless. Men and women who are simply going about the business of trying to survive their lives.

  I think about my life before, living in an apartment on the Upper East Side and working in an ad agency in an office surrounded by false walls, sharing half-hour lunches and two fifteen-minute breaks with colleagues sitting in their own makeshift offices. A honeycomb of cubicles beneath fluorescent lights. I think about losing my job. I think about all of the pharmaceutical drugs I've tested in order to earn a living and what they've done to me. I think about the kid on the skateboard and Vic's confession.